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STDs (Expert Forum)
FINAL POSSIBILITY IN INGOING STRESSFUL CASE
Answered by
University of Washington
Seattle - WA
Welcome to the STD Forum, which is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.
FINAL POSSIBILITY IN INGOING STRESSFUL CASE
by needtoseesense, Nov 01, 2009 06:15PM
Either Doctor, sorry to return with yet another post. I have access to only basic ned care due to where I am right now and am very concerned about the problem that has been followed on this forum so far.
A quick read of my previous threads will show the history if you have time.
Firstly I was diagnosed with NGU
Both of us took treatment.
6 weeks after NGU, I get rash on head - assumed thrush and treated.
At the same time my partner had some discharge and itch. The discharge had an odour. Around this time after sex I noticed I was covered in a white discharge from my partner (she treated what she thought was yeast the week before by putting a tablet up there – could have been that though a week old is unlikely.
She went to the GUM clinic for the examination and they looked at a swab under microscope and diagnosed BV. She took the med. We abstained.
We had sex without probs a few weeks later then the time after I came down with bad red rash all over the head, itch, slight clear/cloudy discharge, foreskin difficult to pull back, white cheesy stuff under foreskin/ foul odour/ need to urinate more. Don’t think my g/f had symptoms that time. I washed it a lot and abstained. Cleared up. Weeks later (now) we had sex and once again I got the red raised rash all over the head/ foul odour/itch/ most cleared with canestan this time though I have what feels like an NGU again. Urethra is v painful and I urinate a lot. It doesn’t burn so much. I have seen no discharge yet. My g/f again has some itch/clear/cloudy discharge and odour. She is taking another round of metroniddazole and it seems to be working for her.
Do you think it is reasonable to suppose trich is causing the situation I describe?
My symptoms are worse then hers but the reappearance of (a not diagnosed) but feels very like an NGU would worry me. I have no idea where trich would come from.
all activity seems around her period too.
This really is the final question before my doc visit here.
Doctor's Answer
by H. Hunter Handsfield, M.D., Nov 01, 2009 10:20PM
, Nov 01, 2009 10:20PM
Welcome back. But I doubt we can help very much. You have a complex situation which is not typical, and probably not due to any traditional STD. Direct health care by a knowledgeable provider is the only way these dilemmas are going to be sorted out.
When trichomonas causes symptoms in women, usually it is readily diagnosed under a micrcoscope. And although there are similarities in symptoms and signs with BV (similar odor, for example) and respond to the some of the same treatments (including metronidazole), the two conditions are pretty easy to tell apart by a knowledgeable clinician. Therefore, it is unlikely your partner or you have trich. That said, you could discuss this with your provider. BV often recurs (more than half the time), without sexual reexposure. So reappearnce of your partner's symptoms does not necessarily suggest trich or anything else. As for your symptoms, it isn't possible for me to judge or to be certain anything is acually wrong. That will require direct examination.
I can't tell from your questions whether you and your partner are under simultaneous care by the same GUM clinic. That would make a lot of sense -- i.e. make appointments to be seen at the same time, preferably by the same provider. With luck, that will help clear things up. If not, I'm sorry that this forum -- or any distant consultant, without direct examination -- is likely to be able to help you.
Good luck-- HHH, MD
When trichomonas causes symptoms in women, usually it is readily diagnosed under a micrcoscope. And although there are similarities in symptoms and signs with BV (similar odor, for example) and respond to the some of the same treatments (including metronidazole), the two conditions are pretty easy to tell apart by a knowledgeable clinician. Therefore, it is unlikely your partner or you have trich. That said, you could discuss this with your provider. BV often recurs (more than half the time), without sexual reexposure. So reappearnce of your partner's symptoms does not necessarily suggest trich or anything else. As for your symptoms, it isn't possible for me to judge or to be certain anything is acually wrong. That will require direct examination.
I can't tell from your questions whether you and your partner are under simultaneous care by the same GUM clinic. That would make a lot of sense -- i.e. make appointments to be seen at the same time, preferably by the same provider. With luck, that will help clear things up. If not, I'm sorry that this forum -- or any distant consultant, without direct examination -- is likely to be able to help you.
Good luck-- HHH, MD
Post Comment
The urethral pain got severe after writing last time. Very distinct, sharp cutting pain inside. There was some discharge I believe. No underwear stains and none in the morning but once or twice I felt a slight mucous during the day.
The local pharmacy here gave me 1.5g of zithro and 30x500mg of Flygll. I just asked over the counter as the med centers don’t have the testing facilites.
I started taking 500mg per day 2 days ago. So have had 1g now. On 1st day of taking it the symptoms much improved and the second now – it seems gone. Should I even bother with the other 500mg?
Sorry to harp on about trich – it would seem it is not an option really given my partner has been examined and tested, and as you say, it would have been picked up.
It is an atypical situation and of course no answers can be provided online to sort it out. I send this final email along just to have clarity when we both attend our doctor. Short answers are all I need if you can. - Thanks for everything.
Would an NGU react so quickly to zithro? Same day / next day of taking
Would an NGU caused by trich respond quickly to zithro (my initial NGU responded in a day or two after treatment?)
Should my partner take treatment for NGU again? If this (presumed) second case was NGU perhaps initial treatment failed?
Could trich be responsible for my partner’s worse cramping pain than she usually has around menses each month? Occurring a few weeks after my initial NGU.
Such symptoms as we experience – only occur the day after intercourse - so are obviously triggered by each other – is that evidence against any typical stds being present?
My partner has now taken 2 courses of Metri – I have the flagll – I thought it might help if I took a course too?
I fully realise medhelp cant tell me what is wrong.
if I could just have an indication on 2 items?
my urethra has actually continued to be irritated and painful - on and off with the meatus slightly pained, desptie the 1g of zithro I took 2 days ago . does this sound like trich?
and very last the only question is - my partners cramps during menses - getting worse, is that somehting associated with any std?
sorry doc - thats it. I will leave it be now and both of us will see a single doc as you suggest. thanks to you and dr hook for your patience during my posts.
no more comments I promise - just wanted to clear that up.
See the GUM clinic and follow their advice. I please stop posting comments. I will have no further replies.